Temporary Target Versus Suspended Insulin Infusion in Patients with Type 1 Diabetes Using the MiniMed 780G Advanced Closed-Loop Hybrid System During Aerobic Exercise: A Randomized Crossover Clinical Trial.

IF 5.7 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes technology & therapeutics Pub Date : 2024-11-01 Epub Date: 2024-09-30 DOI:10.1089/dia.2023.0589
Ana María Gómez, Diana Cristina Henao, Oscar Mauricio Muñoz, Diana Marcela Romero, Julio David Silva León, Pablo Esteban Jaramillo, Evelyn Moscoso, Darío A Parra Prieto, Sofía Robledo, Maira García Jaramillo, Martin Rondón Sepúlveda
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引用次数: 0

Abstract

Aim: To compare the safety in terms of hypoglycemic events and continuous glucose monitoring (CGM) metrics during aerobic exercise (AE) of using temporary target (TT) versus suspension of insulin infusion (SII) in adults with type 1 diabetes (T1D) using advanced hybrid closed-loop systems. Methods: This was a randomized crossover clinical trial. Two moderate-intensity AE sessions were performed, one with TT and one with SII. Hypoglycemic events and CGM metrics were analyzed during the immediate (baseline to 59 min), early (60 min to 6 h), and late (6 to 36 h) post-exercise phases. Results: In total, 33 patients were analyzed (44.6 ± 13.8 years), basal time in range (%TIR 70-180 mg/dL) was 79.4 ± 12%, and time below range (%TBR) <70 mg/dL was 1.8 ± 1.7% and %TBR <54 mg/dL was 0.5 ± 0.9%. No difference was found in the number of hypoglycemic events, %TBR <70 mg/dL and %TBR <54 mg/dL between TT and SII. Differences were found in the early phase, with better values when using TT for %TIR 70-180 mg/dL (83.0 vs. 65.3, P = 0.005), time in tight range (%TITR 70-140 mg/dL) (56.3 vs. 41.5, P = 0.04), and time above range (%TAR >180 mg/dL) (15.3 vs. 31.8, P = 0.01). In the diurnal period, again %TIR was better for TT use (82.1 vs. 73.1, P = 0.02) and %TAR (15.0 vs. 22.96, P = 0.04). No significant differences were found in the CGM metrics during the different phases of AE. Conclusion: Our data appear to show that the use of TT compared with SII is equally safe in all phases of AE. However, the use of TT allows for a better glycemic profile in the early phase of exercise.

在有氧运动期间使用 MiniMed 780G 高级闭环混合系统为 1 型糖尿病患者输注临时目标胰岛素与暂停胰岛素。随机交叉临床试验。
目的:比较使用先进混合闭环系统的 1 型糖尿病(T1D)成人患者在有氧运动(AE)期间使用临时目标(TT)与暂停胰岛素输注(SII)的安全性和连续血糖监测(CGM)指标:随机交叉临床试验。进行了两次中等强度的 AE 试验,一次使用 TT,一次使用 SII。在运动后的即时阶段(基线和 59 分钟)、早期阶段(60 分钟至 6 小时)和晚期阶段(6 至 36 小时)对低血糖事件和 CGM 指标进行分析:对 33 名患者进行了分析(44.6±13.8 岁,52% 为男性,在范围内时间(%TIR 70-180 mg/dL)79.4±12%,低于范围时间(%TBR)180mg/dL)(15.3 对 31.8,P=0.01)。在体力活动的不同阶段,CGM 指标没有发现明显差异。在评估昼夜时间段时,使用 TT 的 TIR% 较高(82.1 vs. 73.1,p=0.02),使用 SII 的 TAR% 较高(15.0 vs. 22.96,p=0.04),但低血糖事件的数量或低于量程时间(%TBR)的变化没有差异:与 SII 相比,使用 TT 在 AE 的即时、早期和晚期阶段同样安全。不过,使用 TT 可以在运动早期获得更好的血糖状况。
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来源期刊
Diabetes technology & therapeutics
Diabetes technology & therapeutics 医学-内分泌学与代谢
CiteScore
10.60
自引率
14.80%
发文量
145
审稿时长
3-8 weeks
期刊介绍: Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.
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